This is an attempt to affect a reduction in maternal and infant mortality in a defined area by integration of a number of existing components of health services for pregnant women. 1. Educate traditional birth attendants in the use of triage for pregnant women, and referral to higher level of care for high risk. 2. Upgrade primary and secondary health facilities. 3. Set up an effective transportation and communication system. 4. Provide information, education and communication (IEC) to women and their families. 5. Improve the working relationship between the traditional birth attendants and the primary health facilities. This project is implemented through a quasi-experimental design with about 16 villages serving as intervention sites and another 16 as control sites.